Filariasis is a common parasitic infection in which microfilariae (larvae) of the parasite, Wucheria bancrofti, invade and obstruct the lymphatics. It causes massive oedema, especially in the legs. However, they never affect the axillary lymph nodes which makes this case of filariasis in axilla, both unique and interesting.
A 21 year old Indian labourer presented with a complaint of mass in his left axilla which according to him appeared 6 months ago. There was no pain or fever associated with the mass. Moreover, there were no other swellings on his body either.
On physical examination, doctors located the mass in the center of the patient’s left axilla. His mass was non-tender and did not have any associated symptoms. The doctors diagnosed it as tubercular axillary lymphadenitis.
Fine Needle Aspiration Reveals Filariasis
The patient’s blood samples showed normal levels of eosinophils and the absence of any parasitic infection. Doctors also took a chest X ray which was completely normal. In addition, they did an ultrasound of his left axilla, which showed dilated lymphatics. Fine needle aspiration from these dilated lymphatics followed by microscopic examination of the aspirate revealed the presence of microfilariae of Wucheria bancrofti, indicating filariasis.
The doctors treated him with diethylcarbamazine. It helped in the reduction of the size of the mass and of the lymphatic channels as observed on a follow-up ultrasound after 3 weeks.
An Unusual Case
Filariasis usually involves the inguinal lymphatics and results in an edematous lower limb. Hence, it’s also called elephantiasis or “elephant foot”. Furthermore, the description of this case, which is a disease in the axilla is very rare.